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Prothrombin factor complex

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https://www.readbyqxmd.com/read/28223937/orthostatic-challenge-shifts-the-hemostatic-system-of-patients-recovered-from-stroke-toward-hypercoagulability
#1
Gerhard Cvirn, Markus Kneihsl, Christine Rossmann, Margret Paar, Thomas Gattringer, Axel Schlagenhauf, Bettina Leschnik, Martin Koestenberger, Erwin Tafeit, Gilbert Reibnegger, Irhad Trozic, Andreas Rössler, Franz Fazekas, Nandu Goswami
Aims: The objective of our study was to assess the effects of orthostatic challenge on the coagulation system in patients with a history of thromboembolic events and to assess how they compared with age-matched healthy controls. Methods: Twenty-two patients with histories of ischemic stroke and 22 healthy age-matched controls performed a sit-to-stand test. Blood was collected prior to- and at the end of- standing in the upright position for 6 min. Hemostatic profiling was performed by determining thrombelastometry and calibrated automated thrombogram values, indices of thrombin generation, standard coagulation times, markers of endothelial activation, plasma levels of coagulation factors and copeptin, and hematocrit...
2017: Frontiers in Physiology
https://www.readbyqxmd.com/read/28219635/direct-oral-anticoagulant-or-warfarin-related-major-bleeding-characteristics-reversal-strategies-and-outcomes-from-a-multi-center-observational-study
#2
Yan Xu, Sam Schulman, Dar Dowlatshahi, Anne M Holbrook, Christopher S Simpson, Lois E Shepherd, Philip S Wells, Antonio Giulivi, Tara Gomes, Muhammad Mamdani, Wayne Khuu, Eliot Frymire, Ana P Johnson
BACKGROUND: Direct oral anticoagulants (DOACs) have expanded the armamentarium for antithrombotic therapy. While DOAC-related major bleeds were associated with favourable outcomes compared to warfarin in clinical trials, warfarin was reversed in <40% of cases, raising concerns about the generalizability of this finding. METHODS: Consecutive patients ≥66 years presenting to five tertiary care hospitals across three cities in Ontario, Canada with diagnoses that included hemorrhage from October 2010 to March 2015...
February 17, 2017: Chest
https://www.readbyqxmd.com/read/28197273/clinical-and-surgical-strategies-for-avoiding-or-reducing-allogeneic-blood-transfusions
#3
Antonio Alceu Dos Santos, Jose Francisco Baumgratz, Jose Henrique Andrade Vila, Rodrigo Moreira Castro, Rodrigo Freire Bezerra
Blood transfusions have still been used as a standard therapy to treat severe anemia. Current evidences point to both excessive allogeneic blood consumption and decreased donations, which result in reduced stocks in blood banks. Several studies have increasingly suggested a more restrictive transfusion practice for blood products. Currently, a number of autologous blood conservation protocols in surgeries have been noted. We report a case of severe anemia with 2.9 g/dL hemoglobin, which was successfully handled without using the standard therapy to treat anemia with hemotransfusions...
April 2016: Cardiology Research
https://www.readbyqxmd.com/read/28191640/pathogen-safety-of-a-pasteurized-four-factor-human-prothrombin-complex-concentrate-preparation-using-serial-20n-virus-filtration
#4
Thomas Nowak, Birgit Popp, Albrecht Gröner, Wolfram Schäfer, Uwe Kalina, Karlheinz Enssle, Nathan J Roth
BACKGROUND: Beriplex P/N/Kcentra/Coaplex/Confidex is a four-factor human prothrombin complex concentrate (PCC). Here, we describe the pathogen safety profile and biochemical characteristics of an improved manufacturing process that further enhances the virus safety of Beriplex P/N. STUDY DESIGN AND METHODS: Samples of product intermediates were spiked with test viruses, and prions were evaluated under routine production and robustness conditions of the scale-down version of the commercial manufacturing process for their capacity to inactivate or remove pathogens...
February 12, 2017: Transfusion
https://www.readbyqxmd.com/read/28161220/comparison-of-the-safety-and-efficacy-between-3-factor-and-4-factor-prothrombin-complex-concentrates-for-the-reversal-of-warfarin
#5
Julia E Kuroski, Sarah Young
PURPOSE: Prior to the Food and Drug Administration approval of 4-factor prothrombin complex concentrate (4F-PCC), only 3-factor PCC (3F-PCC) products were available in the US. There is limited data comparing the safety and efficacy of 3F-PCC versus 4F-PCC. The purpose of our study, therefore, was to compare the safety and efficacy profiles of 3F-PCC versus 4F-PCC for the emergent reversal of warfarin. METHODS: A single-center, retrospective cohort analysis compared patients who received 3F-PCC or 4F-PCC for the emergent reversal of warfarin due to life-threating bleeding from January 2013 to September 2015...
January 24, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28151386/clinical-experience-reversing-factor-xa-inhibitors-with-four-factor-prothrombin-complex-concentrate-in-a-community-hospital
#6
Katie B Tellor, Naomi S Barasch, Brian M Lee
No abstract text is available yet for this article.
January 24, 2017: Blood Transfusion, Trasfusione del Sangue
https://www.readbyqxmd.com/read/28150393/acquired-hemophilia-a-manifesting-as-plasma-transfusion-uncontrolled-severe-bleeding-2-weeks-after-chorioamnionitis-induced-abortion
#7
Ayumi Matsuoka, Hiromasa Sasaki, Chiharu Sugimori, Shinya Hirabuki, Tsutomu Hoshiba, Hiroshi Fujiwara
Acquired hemophilia A (AHA) is a serious and rare complication of pregnancy, caused by autoantibodies to coagulation factor VIII after delivery. We here report the case of a 36-year-old primigravida woman who developed AHA following chorioamnionitis-caused miscarriage in the second trimester. Thirteen days after abortion, sudden, massive vaginal bleeding occurred with marked prolongation of activated partial thromboplastin time (APTT) in the absence of other abnormal coagulation data. Sequential transfusion of fresh frozen plasma did not achieve normalization of APTT...
February 2, 2017: Journal of Obstetrics and Gynaecology Research
https://www.readbyqxmd.com/read/28125808/coagulation-management-in-jersey-calves-an-ex-vivo-study
#8
Sabine Gröning, Judith Maas, Svenja van Geul, Rolf Rossaint, Ulrich Steinseifer, Oliver Grottke
OBJECTIVE: Jersey calves are frequently used as an experimental animal model for in vivo testing of cardiac assist devices or orthopedic implants. In this ex vivo study, we analyzed the coagulation system of the Jersey calves and the potential of human-based coagulation management to circumvent perioperative bleeding complications during surgery. Experimental Procedure: Blood from 7 Jersey calves was subjected to standard laboratory tests and thromboelastometry analysis. An ex vivo model of dilutional coagulopathy was used to study the effects of fibrinogen or prothrombin complex concentrate supplementation...
January 27, 2017: European Surgical Research. Europäische Chirurgische Forschung. Recherches Chirurgicales Européennes
https://www.readbyqxmd.com/read/28124406/recombinant-porcine-factor-viii-for-high-risk-surgery-in-paediatric-congenital-haemophilia-a-with-high-titre-inhibitor
#9
S E Croteau, Y L Abajas, A S Wolberg, B I Nielsen, G R Marx, C W Baird, E J Neufeld, P E Monahan
INTRODUCTION: High-titre factor VIII (FVIII) inhibitors complicate peri-operative haemostasis. Recombinant porcine FVIII (r-pFVIII) may provide an alternative haemostatic agent for high-risk procedures and allow FVIII activity monitoring. AIM: Devise an effective haemostatic plan for repair of a progressively symptomatic aortic coarctation in a 5-year-old male with immune tolerance induction (ITI) refractory high-titre FVIII inhibitors. METHODS: Preprocedure human FVIII inhibitor titre was 58 Bethesda Units mL(-1) (BU) and cross-reacted to neutralize porcine FVIII at 30 BU...
January 25, 2017: Haemophilia: the Official Journal of the World Federation of Hemophilia
https://www.readbyqxmd.com/read/28079537/successful-total-hip-replacement-with-sequential-administration-of-bypassing-agents-in-an-adolescent-boy-with-hemophilia-a-and-high-inhibitor-titers
#10
Zühre Kaya, Özlem Orhan, Sacit Turanl, İdil Yenicesu, Ülker Koçak, Türkiz Gürsel
There are only a few reports of total hip replacement in patients with hemophilia A and inhibitors. We performed total hip replacement in an 18-year-old adolescent boy who had high inhibitor titers since infancy. Recombinant factor VIIa (NovoSeven) was used as a bypass agent during the surgery. There was no excessive introperative bleeding; however, postsurgical bleeding occurred and was controlled by sequential administration of recombinant factor VIIa and activated prothrombin complex concentrate (FEIBA)...
January 12, 2017: Blood Coagulation & Fibrinolysis: An International Journal in Haemostasis and Thrombosis
https://www.readbyqxmd.com/read/28060970/-evaluation-of-oral-anticoagulation-with-rivaroxaban-in-patients-with-new-onset-non-valvular-atrial-fibrillation
#11
Víctor Neira, Ramón Corbalán, Jaime Pereira, Olga Panes, Bernardita Garayar, Andrés Aizman, Silvana Llevaneras, Luis Villarroel
BACKGROUND: Atrial fibrillation (AF) generates a hypercoagulable state with an increased thrombin generation and raised levels of thrombin-antithrombin complexes, which results in a high risk of stroke and thromboembolism. AIM: To evaluate the anticoagulant effect of rivaroxaban by anti-Xa factor activity and its correlation with thrombin-antithrombin complexes, thrombin generation and prothrombin time in patients newly diagnosed with non-valvular AF. PATIENTS AND METHODS: Prospective study in patients with indication of anticoagulation...
September 2016: Revista Médica de Chile
https://www.readbyqxmd.com/read/28004432/role-of-coagulation-factors-in-urological-malignancy-a-prospective-controlled-study-on-prostate-renal-and-bladder-cancer
#12
Aristeidis Alevizopoulos, Stavros Tyritzis, Ioannis Leotsakos, Ioanna Anastasopoulou, Christos Pournaras, Paraskevi Kotsis, Olga Katsarou, Christos Alamanis, Konstantinos Stravodimos, Constantinos Constantinides
OBJECTIVES: To study the behavior of specific coagulation factors in different types of non-metastatic urological cancers, and to identify their possible role as diagnostic and prognostic markers. METHODS: This was a prospective controlled study, which included three cancer patient groups and a control group of healthy individuals. The cancer subgroups consisted of renal (n = 44), prostate (n = 56) and bladder cancer (n = 47). We excluded patients receiving anticoagulant therapy, or with significant comorbidity...
December 22, 2016: International Journal of Urology: Official Journal of the Japanese Urological Association
https://www.readbyqxmd.com/read/27975099/paradoxical-bleeding-and-thrombotic-episodes-of-dysprothrombinaemia-due-to-a-homozygous-arg382his-mutation
#13
Qiulan Ding, Likui Yang, Xiaoqing Zhao, Wenman Wu, Xuefeng Wang, Alireza R Rezaie
We have characterised the pathogenic basis of dysprothrombinaemia in a patient exhibiting paradoxical bleeding and thrombotic defects during pregnancy and postpartum. Genetic analysis revealed that the proband is homozygous for the prothrombin Arg382His mutation, possessing only ~1 % clotting activity. The proband experienced severe bleeding episodes during her pregnancy, which required treatment with prothrombin complex concentrates, and then pulmonary embolism and deep-vein thrombosis at 28 days postpartum, which required treatment with LMWH and fresh frozen plasma...
December 15, 2016: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/27970893/cost-minimization-of-using-activated-prothrombin-complex-concentrate-versus-recombinant-activated-factor-vii-in-patients-with-a-nd-b-hemophilia-in-presence-of-inhibitors
#14
M E Romero Prada, F Gomez de la Rosa, N J Alvis-Zakzuk, M Carrasquilla-Sotomayor, J S Alvis-Zakzuk, J Zakzuk-Sierra
No abstract text is available yet for this article.
November 2016: Value in Health: the Journal of the International Society for Pharmacoeconomics and Outcomes Research
https://www.readbyqxmd.com/read/27942737/prothrombin-complex-concentrates-an-alternative-to-fresh-frozen-plasma
#15
David R Burk, Jordan L Smith, Jason R Wild
Insufficiency fractures are a common cause of morbidity among geriatric patients worldwide. Improved outcomes are known to result from decreased delay to definitive operative fixation and mobilization. Use of warfarin is an important potential cause of delay. The ideal mode of warfarin reversal is currently unknown. Prothrombin complex concentrates (PCCs) offer rapid correction with small infusion volume, both of which are important for elderly patients with multiple comorbidities. The authors present 2 cases of insufficiency fractures occurring in geriatric patients receiving warfarin therapy reversed with a 3-factor PCC...
December 8, 2016: Orthopedics
https://www.readbyqxmd.com/read/27940453/perioperative-management-of-the-bleeding-patient
#16
K Ghadimi, J H Levy, I J Welsby
Perioperative bleeding remains a major complication during and after surgery, resulting in increased morbidity and mortality. The principal causes of non-vascular sources of haemostatic perioperative bleeding are a preexisting undetected bleeding disorder, the nature of the operation itself, or acquired coagulation abnormalities secondary to haemorrhage, haemodilution, or haemostatic factor consumption. In the bleeding patient, standard therapeutic approaches include allogeneic blood product administration, concomitant pharmacologic agents, and increasing application of purified and recombinant haemostatic factors...
December 2016: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/27917717/reversal-agents-for-oral-antiplatelet-and-anticoagulant-treatment-during-bleeding-events-current-strategies
#17
Peter Raimondi, Elaine M Hylek, Konstantinos N Aronis
There is an increasing prevalence of cardiovascular diseases that warrant antithrombotic therapy. Antithrombotic therapy includes antiplatelet agents and anticoagulation therapy with vitamin K antagonists (VKAs) or non-Vitamin K oral anticoagulants (NOACs). Antithrombotic therapy is associated with increased rates of bleeding. In this review we summarize the evidence and provide strategies for the management of severe bleeding in the setting of antithrombotic therapy. There is limited data on the management of bleeding in the setting of antiplatelet therapy...
December 5, 2016: Current Pharmaceutical Design
https://www.readbyqxmd.com/read/27913543/hemophilia-and-inhibitors-current-treatment-options-and-potential-new-therapeutic-approaches
#18
Shannon L Meeks, Glaivy Batsuli
The immune response to infused factor concentrates remains a major source of morbidity and mortality in the treatment of patients with hemophilia A and B. This review focuses on current treatment options and novel therapies currently in clinical trials. After a brief review of immune tolerance regimens, the focus of the discussion is on preventing bleeding in patients with hemophilia and inhibitors. Recombinant factor VIIa and activated prothrombin complex concentrates are the mainstays in treating bleeds in patients with inhibitors...
December 2, 2016: Hematology—the Education Program of the American Society of Hematology
https://www.readbyqxmd.com/read/27902939/factor-xiii-deficiency-enhances-thrombin-generation-due-to-impaired-fibrin-polymerization-an-effect-corrected-by-factor-xiii-replacement
#19
Hanna H Pitkänen, Annukka Jouppila, Marja Lemponen, Minna Ilmakunnas, Jouni Ahonen, Riitta Lassila
INTRODUCTION: Factor XIII (FXIII) cross-links fibrin, completing blood coagulation. Congenital FXIII deficiency is managed with plasma-derived FXIII (pdFXIII) or recombinant FXIII (rFXIII) concentrates. AIM: As the mechanisms protecting patients with low FXIII levels (<5IU/dL) from spontaneous bleeds remain unknown we assessed the interplay between thrombin generation (TG), fibrin formation and clot kinetics before and after FXIII administration in three patients with FXIII deficiency...
January 2017: Thrombosis Research
https://www.readbyqxmd.com/read/27895055/role-of-agents-for-reversing-the-effects-of-target-specific-oral-anticoagulants
#20
REVIEW
Tanya R Riley, Mary L Gauthier-Lewis, Chelsea K Sanchez, Janine S Douglas
PURPOSE: The available clinical data on target-specific oral anticoagulant (TSOAC) reversal agents that are currently in development or have been approved by the Food and Drug Administration (FDA) are reviewed. SUMMARY: The development of TSOACs such as dabigatran, rivaroxaban, edoxaban, and apixaban has presented benefits and new challenges. One of the main challenges associated with the use of TSOACs is the lack of suitable agent-specific reversal agents. Several treatment options for the management of life-threatening bleeding events associated with TSOAC use, such as fresh frozen plasma, prothrombin complex concentrates, and recombinant coagulation factor VIIa, have been used, with inconsistent results...
January 15, 2017: American Journal of Health-system Pharmacy: AJHP
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